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The aim of this in vitro study was to evaluate the morphological effects of Er:YAG laser (KaVo Key II) irradiation on artificial enamel caries lesions and its ability to arrest the progression of these lesions. The sample (120 enamel blocks from primary teeth) was previously submitted to pH-cycling and then randomly divided into the groups. In the morphological analysis, the specimens were subdivided into 4 groups: control (C), focused laser (LC), defocused laser 3mm (L3), defocused laser 6mm (L6) and then prepared for scanning electron microscopy. To evaluate the effectiveness of the laser on incipient caries lesions, the specimens were divided into 9 groups: negative control (NC), positive control (PC), focused laser (LC), defocused laser 3mm (L3), defocused laser 6mm (L6), topical fluoride application (F), LC and fluoride (LCF), L3 and fluoride (L3F) and L6 and fluoride (L6F). All groups were submitted once again to ph cycling (except NC) and prepared for polarized light microscopy. ANOVA and LSD statistical tests were used. Images were also observed under stereoscopic loupe and were submitted to Chi-square test, Fishers ́ exact test and reproducibility assessment. Visual and morphological evaluations showed that superficial ablation was present on the artificial white spot caries lesions in group LC, porosity increase in group L3 and no morphological alteration in group L6. Results under polarized light microscopy showed that laser irradiation and fluoride was able to arrest the caries progression in groups LCF, L3F and L6F and reduce the lesion ́s depth in L6F. In conclusion, it was detected that the association of Er:YAG defocused laser 6mm irradiation and fluoride was able to reduce the depth of the artificial incipient caries lesions without producing any morphological alteration and that the association of laser and fluoride was effective in arresting incipient caries lesions . Uniterms: Er:YAG Laser; Dental white spots; Topical fluorides; Primary teeth; Enamel; Demineralization. LISTA DE ILUSTRAÇÕES Figura 4.1 Seleção e preparo da amostra para desenvolvimento de lesões artificiais de cárie incipiente53 Figura 4.2 Diagrama do estudo preliminar: determinação dos parâmetros56 Figura 4.3 Tratamento e preparo dos espécimes para Microscopia Eletrônica de Varredura (MEV)60 Figura 4.4 Preparo dos espécimes para microscopia de luz polarizada63 Figura 5.1 Imagens dos espécimes do grupo controle68 Figura 5.2 Imagens dos espécimes do grupo laser de Er:YAG focado69 Figura 5.3 Imagens dos espécimes do grupo laser de Er:YAG desfocado 3 mm70 Figura 5.4 Imagens dos espécimes do grupo laser de Er:YAG desfocado 6 mm71 Figura 5.5 Imagens obtidas através da lupa estereoscópica dos espécimes analisados (aumento 20X) e por microscopia de luz polarizada (aumento 20X) dos diferentes grupos experimentais73 Figura 5.6 Gráfico representando as médias de profundidade das lesões (μm) nos diferentes grupos experimentais. Letras diferentes mostram diferença estatisticamente significante entre os grupos (p<0.05) e a distância entre as barras denota os desvios padrões74

Avaliação in vitro da morfologia e da capacidade de paralisação de lesões incipientes de cárie artificialmente induzidas em dentes decíduos após irradiação com Laser de Er:YAG